Individual provider Active NPI

Vincent John Murray, DDS

  • General Practice Dentistry
  • Georgetown, SC
National Provider Identifier
1316163041
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
541572469 Issued in VA
Practice address
1209 N Fraser St
Georgetown, SC 29440-2853
Phone
(435) 462-2738
Fax
(843) 546-7777
NPI assigned
Apr 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 541572469 VA Primary

Addresses

Primary practice location

1209 N Fraser St
Georgetown, SC 29440-2853

Mailing address

5 Rock Pointe LN
Suite 100
Warrenton, VA 20186-2632
Phone (540) 349-0056

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
541572469VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
John a. Miller, DMD, LLC General Practice PastSince Oct 22, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1316163041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 ROCK POINTE LN",
            "address_2": "SUITE 100",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "201862632",
            "telephone_number": "540-349-0056",
            "fax_number": "540-349-0013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 N FRASER ST",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294402853",
            "telephone_number": "435-462-2738",
            "fax_number": "843-546-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRAY",
        "first_name": "VINCENT",
        "middle_name": "JOHN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2023-10-16",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "541572469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.